The Third Great Plague pot

The Third Great Plague CHAPTER I CHAPTER I CHAPTER II CHAPTER II CHAPTER III CHAPTER III CHAPTER IV CHAPTER IV CHAPTER V CHAPTER V CHAPTER VI CHAPTER VI CHAPTER VII CHAPTER VII CHAPTER VIII CHAPTER VIII CHAPTER IX CHAPTER IX CHAPTER X CHAPTER X CHAPTER XI CHAPTER XI CHAPTER XII CHAPTER XII CHAPTER XIII CHAPTER XIII CHAPTER XIV CHAPTER XIV CHAPTER XV 1 CHAPTER XV CHAPTER XVI CHAPTER XVI Chapter I Chapter I Chapter II Chapter II Chapter III Chapter III Chapter IV Chapter IV Chapter V Chapter V Chapter VI Chapter VI Chapter VII Chapter VII Chapter VIII Chapter VIII Chapter IX Chapter IX Chapter X Chapter X Chapter XI Chapter XI Chapter XII Chapter XII Chapter XIII Chapter XIII Chapter XIV Chapter XIV Chapter XV Chapter XV Chapter XVI Chapter XVI The Third Great Plague The Project Gutenberg EBook of The Third Great Plague, by John H. Stokes This eBook is for the use of anyone anywhere at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.org Title: The Third Great Plague A Discussion of Syphilis for Everyday People Author: John H. Stokes Release Date: May 6, 2006 [EBook #18324] Language: English The Third Great Plague 2 Character set encoding: ISO-8859-1 *** START OF THIS PROJECT GUTENBERG EBOOK THE THIRD GREAT PLAGUE *** Produced by Audrey Longhurst, LN Yaddanapudi and the Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images from the Home Economics Archive: Research, Tradition and History, Albert R. Mann Library, Cornell University) The Third Great Plague A Discussion of Syphilis for Everyday People By John H. Stokes, A.B., M.D. Chief of the Section of Dermatology and Syphilology The Mayo Clinic, Rochester, Minnesota Assistant Professor of Medicine The Mayo Foundation Graduate School of the University of Minnesota Philadelphia and London W. B. Saunders Company 1920 Published, November, 1917 Copyright, 1917, by W. B. Saunders Company Reprinted July, 1918 Reprinted February, 1920 PRINTED IN AMERICA PREFACE The struggle of man against his unseen and silent enemies, the lower or bacterial forms of life, once one becomes alive to it, has an irresistible fascination. More dramatic than any novel, more sombre and terrifying than a battle fought in the dark, would be the intimate picture of the battle of our bodies against the hosts of disease. If we could see with the eye of the microscope and feel and hear with the delicacy of chemical and physical interactions between atoms, the heat and intensity and the savage relentlessness of that battle would blot out all perception of anything but itself. Just as there are sounds we cannot hear, and light we cannot see, so there is a world of small things, living in us and around us, which sways our destiny and carries astray the best laid schemes of our wills and personalities. The gradual development of an awareness, a realization of the power of this world of minute things, has been the index of progress in the bodily well-being of the human race through the centuries marking the rebirth of medicine after the sleep of the Dark Ages. In these days of sanitary measures and successful public health activity, it is becoming more and more difficult for us to realize the terrors of the Black Plagues, the devastation, greater and more frightful than war, which centuries ago swept over Europe and Asia time and again, scarcely leaving enough of the living to bury the dead. Cholera, smallpox, bubonic plague, with terrifying suddenness fell upon a world of ignorance, and each in turn humbled humanity to the dust before its invisible enemies. Even within our own recollection, the germ of influenza, gaining a foothold inside our defenses, took the world by storm, and beginning probably at Hongkong, within the years 1889-90, swept the entire habitable earth, affecting hundreds of thousands of The Third Great Plague 3 human beings, and leaving a long train of debilitating and even crippling complications. Here and there through the various silent battles between human beings and bacteria there stand out heroic figures, men whose powers of mind and gifts of insight and observation have made them the generals in our fight against the armies of disease. But their gifts would have been wasted had they lacked the one essential aid without which leadership is futile. This is the force of enlightened public opinion, the backing of the every-day man. It is the coöperation of every-day men, acting on the organized knowledge of leaders, which has made possible the virtual extinction of the ancient scourges of smallpox, cholera, and bubonic plague. Just as certain diseases are gradually passing into history through human effort, and the time is already in sight when malaria and yellow fever, the latest objects of attack, will disappear before the campaign of preventive medicine, so there are diseases, some of them ancient, others of more recent recognition, which are gradually being brought into the light of public understanding. Conspicuous among them is a group of three, which, in contrast to the spectacular course of great epidemics, pursue their work of destruction quietly, slowly undermining, in their long-drawn course, the very foundations of human life. Tuberculosis, or consumption, now the best known of the three, may perhaps be called the first of these great plagues, not because it is the oldest or the most wide-spread necessarily, but because it has been the longest known and most widely understood by the world at large. Cancer, still of unknown cause, is the second great modern plague. The third great plague is syphilis, a disease which, in these times of public enlightenment, is still shrouded in obscurity, entrenched behind a barrier of silence, and armed, by our own ignorance and false shame, with a thousand times its actual power to destroy. Against all of these three great plagues medicine has pitted the choicest personalities, the highest attainments, and the uttermost resources of human knowledge. Against all of them it has made headway. It is one of the ironies, the paradoxes, of fate that the disease against which the most tremendous advances have been made, the most brilliant victories won, is the third great plague, syphilis the disease that still destroys us through our ignorance or our refusal to know the truth. We have crippled the power of tuberculosis through knowledge, wide-spread, universal knowledge, rather than through any miraculous discoveries other than that of the cause and the possibility of cure. We shall in time obliterate cancer by the same means. Make a disease a household word, and its power is gone. We are still far from that day with syphilis. The third great plague is just dawning upon us a disease which in four centuries has already cost a whole inferno of human misery and a heaven of human happiness. When we awake, we shall in our turn destroy the destroyer and the more swiftly because of the power now in the hands of medicine to blot out the disease. To the day of that awakening books like this are dedicated. The facts here presented are the common property of the medical profession, and it is impossible to claim originality for their substance. Almost every sentence is written under the shadow of some advance in knowledge which cost a life-time of some man's labor and self-sacrifice. The story of the conquest of syphilis is a fabric of great names, great thoughts, dazzling visions, epochal achievements. It is romance triumphant, not the tissue of loathsomeness that common misconception makes it. The purpose of this book is accordingly to put the accepted facts in such a form that they will the more readily become matters of common knowledge. By an appeal to those who can read the newspapers intelligently and remember a little of their high-school physiology, an immense body of interested citizens can be added to the forces of a modern campaign against the third great plague. For such an awakening of public opinion and such a movement for wider coöperation, the times are ready. JOHN H. STOKES. ROCHESTER, MINN. CONTENTS PAGE The Third Great Plague 4 CHAPTER I THE HISTORY OF SYPHILIS 11 CHAPTER II SYPHILIS AS A SOCIAL PROBLEM 15 CHAPTER III THE NATURE AND COURSE OF SYPHILIS 21 The Prevalence of Syphilis 24 The Primary Stage 26 CHAPTER IV THE NATURE AND COURSE OF SYPHILIS (Continued) 35 The Secondary Stage 35 CHAPTER V THE NATURE AND COURSE OF SYPHILIS (Continued) 45 Late Syphilis (Tertiary Stage) 45 CHAPTER VI THE BLOOD TEST FOR SYPHILIS 54 CHAPTER VII THE TREATMENT OF SYPHILIS 60 General Considerations 60 Mercury 62 CHAPTER VIII THE TREATMENT OF SYPHILIS (Continued) 70 Salvarsan 70 CHAPTER IX THE CURE OF SYPHILIS 80 CHAPTER X HEREDITARY SYPHILIS 92 CHAPTER I 5 CHAPTER XI THE TRANSMISSION AND HYGIENE OF SYPHILIS 109 CHAPTER XII THE TRANSMISSION AND HYGIENE OF SYPHILIS (Continued) 121 The Control of Infectiousness in Syphilis 121 Syphilis and Marriage 125 CHAPTER XIII THE TRANSMISSION AND HYGIENE OF SYPHILIS (Continued) 133 Syphilis and Prostitution 133 Personal Hygiene of Syphilis 136 CHAPTER XIV MENTAL ATTITUDES IN THEIR RELATION TO SYPHILIS 141 CHAPTER XV MORAL AND PERSONAL PROPHYLAXIS 156 CHAPTER XVI PUBLIC EFFORT AGAINST SYPHILIS 164 INDEX 187 LIST OF ILLUSTRATIONS PAGE PAUL EHRLICH [1854-1915] 69 FRITZ SCHAUDINN [1871-1906] 112 E. ROUX 161 ÉLIE METCHNIKOFF [1845-1916] 161 The Third Great Plague Chapter I The History of Syphilis CHAPTER XI 6 Syphilis has a remarkable history,[1] about which it is worth while to say a few words. Many people think of the disease as at least as old as the Bible, and as having been one of the conditions included under the old idea of leprosy. Our growing knowledge of medical history, however, and the finding of new records of the disease, have shown this view to be in all probability a mistake. Syphilis was unknown in Europe until the return of Columbus and his sailors from America, and its progress over the civilized world can be traced step by step, or better, in leaps and bounds, from that date. It came from the island of Haiti, in which it was prevalent at the time the discoverers of America landed there, and the return of Columbus's infected sailors to Europe was the signal for a blasting epidemic, which in the sixteenth and seventeenth centuries devastated Spain, Italy, France, and England, and spread into India, Asia, China, and Japan. [1] For a detailed account in English, see Pusey, W. A.: "Syphilis as a Modern Problem," Amer. Med. Assoc., 1915. It is a well-recognized fact that a disease which has never appeared among a people before, when it does attack them, spreads with terrifying rapidity and pursues a violent and destructive course on the new soil which they offer. This was the course of syphilis in Europe in the years immediately following the return of Columbus in 1493. Invading armies, always a fruitful means of spreading disease, carried syphilis with them everywhere and left it to rage unchecked among the natives when the armies themselves went down to destruction or defeat. Explorers and voyagers carried it with them into every corner of the earth, so that it is safe to say that in this year of grace 1917 there probably does not exist a single race or people upon whom syphilis has not set its mark. The disease, in four centuries, coming seemingly out of nowhere, has become inseparably woven into the problems of civilization, and is part and parcel of the concerns of every human being. The helpless fear caused by the violence of the disease in its earlier days, when the suddenness of its attack on an unprepared people paralyzed comprehension, has given place to knowledge such as we can scarcely duplicate for any of the other scourges of humanity. The disease has in its turn become more subtle and deceiving, its course is seldom marked by the bold and glaring destructiveness, the melting away of resistance, so familiar in its early history. The masses of sores, the literal falling to pieces of skeletons, are replaced by the inconspicuous but no less real deaths from heart and brain and other internal diseases, the losses to sight and hearing, the crippling and death of children, and all the insidious, quiet deterioration and degeneration of our fiber which syphilis brings about. From devouring a man alive on the street, syphilis has taken to knifing him quietly in his bed. Although syphilis sprang upon the world from ambush, so to speak, it did the world one great service it aroused Medicine from the sleep of the Middle Ages. Many of the greatest names in the history of the art are inseparably associated with the progress of our knowledge of this disease. As Pusey points out, it required the force of something wholly unprecedented to take men away from tradition and the old stock in trade of ideas and formulas, and to make them grasp new things. Syphilis was the new thing of the time in the sixteenth century and the study which it received went far toward putting us today in a position to control it. Before the beginning of the twentieth century almost all that ordinary observation of the diseased person could teach us was known of syphilis. It needed only laboratory study, such as has been given it during the past fifteen years, to put us where we could appeal to every intelligent man and woman to enlist in a brilliantly promising campaign. For a time syphilis was confused with gonorrhea, and there could be no better proof of the need for separating the two in our minds today than to study the way in which this confusion set back progress in our knowledge of syphilis. John Hunter, who fathered the idea of the identity of the two diseases, sacrificed his life to his idea indirectly. Ricord, a Frenchman, whose name deserves to be immortal, set Hunter's error right, and as the father of modern knowledge of syphilis, prepared us for the revolutionary advances of the last ten years. There is something awe-inspiring in the quiet way in which one great victory has succeeded another in the battle against syphilis in the last decade. If we are out of the current of these things, in the office or the store, or in the field of industry and business, announcements from the great laboratories of the world seldom reach us, and when they do, they have an impractical sound, an unreality for us. So one hears, as if in a Chapter I 7 speaking-tube from a long distance, the words that Schaudinn and Hoffmann, on April 19, 1905, discovered the germ that causes syphilis, not realizing that the fact contained in those few brief words can alter the undercurrent of human history, and may, within the lives of our children and our children's children, remake the destiny of man on the earth. A great spirit lives in the work of men like Metchnikoff and Roux and Maisonneuve, who made possible the prophylaxis of syphilis, in that of Bordet and Wassermann, who devised the remarkable blood test for the disease, and in that of Ehrlich and Hata, who built up by a combination of chemical and biological reasoning, salvarsan, one of the most powerful weapons in existence against it. Ehrlich conceived the whole make-up and properties of salvarsan when most of us find it a hardship to pronounce its name. Schaudinn saw with the ordinary lenses of the microscope in the living, moving germ, what dozens can scarcely see today with the germ glued to the spot and with all the aid of stains and dark-field apparatus. After all, it is brain-power focused to a point that moves events, and to the immensity of that power the history of our growing knowledge of syphilis bears the richest testimony. Chapter II Syphilis as a Social Problem The simple device of talking plain, matter-of-fact English about a thing has a value that we are growing to appreciate more and more every day. It is only too easy for an undercurrent of ill to make headway under cover of a false name, a false silence, or misleading speech. The fact that syphilis is a disease spread to a considerable extent by sexual relations too often forces us into an attitude of veiled insinuation about it, a mistaken delicacy which easily becomes prudish and insincere. It is a direct move in favor of vulgar thinking to misname anything which involves the intimacies of life, or to do other than look it squarely in the eye, when necessity demands, without shuffling or equivocation. On this principle it is worth while to meet the problem of a disease like syphilis with an open countenance and straightforward honesty of expression. It puts firm ground under our feet to talk about it in the impersonal way in which we talk about colds and pneumonia and bunions and rheumatism, as unfortunate, but not necessarily indecent, facts in human experience. Nothing in the past has done so much for the campaign against consumption as the unloosing of tongues. There is only one way to understand syphilis, and that is to give it impartial, discriminating discussion as an issue which concerns the general health. To color it up and hang it in a gallery of horrors, or to befog it with verbal turnings and twistings, are equally serious mistakes. The simple facts of syphilis can appeal to intelligent men and women as worthy of their most serious attention, without either stunning or disgusting them. It is in the unpretentious spirit of talking about a spade as a spade, and not as "an agricultural implement for the trituration of the soil," that we should take stock of the situation and of the resources we can muster to meet it. +The Confusion of the Problem of Syphilis with Other Issues.+ Two points in our approach to the problem of syphilis are important at the outset. The first of these is to separate our thought about syphilis from that of the other two diseases, gonorrhea, or "clap," and chancroids, or "soft sores," which are conventionally linked with it under the label of "venereal diseases."[2] The second is to separate the question of syphilis at least temporarily from our thought about morals, from the problem of prostitution, from the question as to whether continence is possible or desirable, whether a man should be true to one woman, whether women should be the victims of a double standard, and all the other complicated issues which we must in time confront. Such a picking to pieces of the tangle is simply the method of scientific thought, and in this case, at least, has the advantage of making it possible to begin to do something, rather than saw the air with vain discussion. [2] The three so-called venereal diseases are syphilis, gonorrhea, and chancroid or soft ulcer. Gonorrhea is the commonest of the three, and is an exceedingly prevalent disease. In man its first symptom is a discharge of pus from the canal through which the urine passes. Its later stages may involve the bladder, the testicles, and other important glands. It may also produce crippling forms of rheumatism, and affect the heart. Gonorrhea may recur, become latent, and persist for years, doing slow, insidious damage. It is transmitted largely by sexual intercourse. Gonorrhea in women is frequently a serious and even fatal disease. It usually renders Chapter II 8 women incapable of having children, and its treatment necessitates often the most serious operations. Gonorrhea of the eyes, affecting especially newborn children, is one of the principal causes of blindness. Gonorrhea may be transmitted to little girls innocently from infected toilet seats, and is all but incurable. Gonorrhea, wherever it occurs, is an obstinate, treacherous, and resistant disease, one of the most serious of modern medical problems, and fully deserves a place as the fourth great plague. Chancroid is an infectious ulcer of the genitals, local in character, not affecting the body as a whole, but sometimes destroying considerable portions of the parts involved. Let us think of syphilis, then, as a serious but by no means hopeless constitutional disease. Dismiss chancroid as a relatively insignificant local affair, seldom a serious problem under a physician's care. Separate syphilis from gonorrhea for the reason that gonorrhea is a problem in itself. Against its train of misfortune to innocence and guilt alike, we are as yet not nearly so well equipped to secure results. Against syphilis, the astonishing progress of our knowledge in the past ten years has armed us for triumph. When the fight against tuberculosis was brought to public attention, we were not half so well equipped to down the disease as we are today to down syphilis. For syphilis we now have reliable and practical methods of prevention, which have already proved their worth. The most powerful and efficient of drugs is available for the cure of the disease in its earlier stages, and early recognition is made possible by methods whose reliability is among the remarkable achievements of medicine. It is the sound opinion of conservative men that if the knowledge now in the hands of the medical profession could be put to wide-spread use, syphilis would dwindle in two generations from the unenviable position of the third great plague to the insignificance of malaria and yellow fever on the Isthmus of Panama. The influences that stand between humanity and this achievement are the lack of general public enlightenment on the disease itself, and public confusion of the problem with other sex issues for which no such clean-cut, satisfactory solution has been found. Think of syphilis as the wages of sin, as well-earned disgrace, as filth, as the badge of immorality, as a necessary defense against the loathesomeness of promiscuity, as a fearful warning against prostitution, and our advantage slips from us. The disease continues to spread wholesale disaster and degeneration while we wrangle over issues that were old when history began and are progressing with desperate slowness to a solution probably many centuries distant. Think of syphilis as a medical and a sanitary problem, and its last line of defense crumbles before our attack. It can and should be blotted out. +Syphilis, a Problem of Public Health Rather than of Morals.+ Nothing that can be said about syphilis need make us forget the importance of moral issues. The fact which so persistently distorts our point of view, that it is so largely associated with our sexual life, is probably a mere incident, biologically speaking, due in no small part to the almost absurdly simple circumstance that the germ of the disease cannot grow in the presence of air, and must therefore find refuge, in most cases, in the cavities and inlets from the surface of the body. History affords little support to the lingering belief that if syphilis is done away with, licentiousness will overrun the world. Long before syphilis appeared in Europe there was sexual immorality. In the five centuries in which it has had free play over the civilized world, the most optimistic cannot successfully maintain that it has materially bettered conditions or acted as a check on loose morals, though its relation to sexual intercourse has been known. As a morals policeman, syphilis can be obliterated without material loss to the cause of sexual self-restraint, and with nothing but gain to the human race. It is easier to accept this point of view, that the stamping out of syphilis will not affect our ability to grapple with moral problems, and that there is nothing to be gained by refusing to do what can so easily be done, when we appreciate the immense amount of innocent suffering for which the disease is responsible. It must appeal to many as a bigoted and narrow virtue, little better than vice itself, which can derive any consolation in the thought that the sins of the fathers are being visited upon the children, as it watches a half-blind, groping child feel its way along a wall with one hand while it shields its face from the sunlight with the other. There are better ways of paying the wages of sin than this. Best of all, we can attack a sin at its source instead of at its fulfilment. How much better to have kept the mother free from syphilis by giving the father the benefit of our knowledge. The child who reaped his sowing gained nothing morally, and lost its physical Chapter II 9 heritage. Its mother lost her health and perhaps her self-respect. Neither one contributes anything through syphilis to the uplifting of the race. They are so much dead loss. To teach us to avoid such losses is the legitimate field of preventive medicine. On this simplified and practical basis, then, the remainder of this discussion will proceed. Syphilis is a preventable disease, usually curable when handled in time, and its successful management will depend in large part upon the coöperation, not only of those who are victims of it, but of those who are not. It is much more controllable than tuberculosis, against which we are waging a war of increasing effectiveness, and its stamping out will rid humanity of an even greater curse. To know about syphilis is in no sense incompatible with clean living or thinking, and insofar as its removal from the world will rid us of a revolting scourge, it may even actually favor the solution of the moral problems which it now obscures. Chapter III The Nature and Course of Syphilis The simplest and most direct definition of syphilis is that it is a contagious constitutional disease, due to a germ, running a prolonged course, and at one time or another in that course is capable of affecting nearly every part of the body. One of the most important parts of this rather abstract statement is that which relates to the germ. To be able to put one's finger so definitely on the cause of syphilis is an advantage which cannot be overestimated. More than in almost any other disease the identification of syphilis at its very outset depends upon the seeing of the germ that causes it in the discharge from the sore or pimple which is the first evidence of syphilis on the body. On our ability to recognize the disease as syphilis in the first few days of its course depends the greatest hope of cure. On the recognition of the germ in the tissues and fluids of the body has depended our knowledge of the real extent and ravages of the disease. With the knowledge that the germ was related to certain other more familiar forms, Ehrlich set the trap for it that culminated in salvarsan, or "606," the powerful drug used in the modern treatment. By the finding of this same germ in the nervous system in locomotor ataxia and general paralysis of the insane, the last lingering doubt of their syphilitic character was dispelled. Every day and hour the man who deals with syphilis in accordance with the best modern practice brings to bear knowledge that arises from our knowledge of the germ cause of syphilis. No single fact except perhaps the knowledge that certain animals (monkeys and rabbits especially) could be infected with it has been of such immense practical utility in developing our power to deal with it. The germ of syphilis,[3] discovered by Schaudinn and Hoffmann in 1905, is an extremely minute spiral or corkscrew-shaped filament, visible under only the highest powers of the microscope, which increase the area of the object looked at hundreds of thousands of times, and sometimes more than a million of times. Even under such intense magnifications, it can be seen only with great difficulty, since it is colorless in life, and it is hard to color or stain it with dyes. Its spiral form and faint staining have led to its being called the Spirochæta pallida.[4] It is best seen by the use of a special device, called a dark-field illuminator, which shows the germ, like a floating particle in a sunbeam, as a brilliant white spiral against a black background, floating and moving in the secretions taken from the sore in which it is found. Some means of showing the germ should be in the hands of every physician, hospital, or dispensary which makes a claim to recognize and treat syphilis. [3] See frontispiece. [4] Pronounced spi-ro-kee'-ta. +Syphilis a Concealed Disease.+ Syphilis is not a grossly conspicuous figure in our every-day life, as leprosy was in the life of the Middle Ages, for example. To the casually minded, therefore, it is not at all unreasonable to ask why there should be so much agitation about it when so little of it is in evidence. It takes a good deal out of the graphic quality of the thing to say that most syphilis is concealed, that most syphilitics, during a Chapter III 10 [...]... believed that the child could have syphilis and the mother escape infection The child's infection was supposed to occur through the infection of the sperm cells of the father with the germ of syphilis When the sperm and the egg united in the mother's body, and the child developed, it was supposed to have syphilis contracted from the father, and the mother was supposed to escape it entirely in the majority... contain the germs, but they have not been shown to be present either in the egg cells of the female or in the sperm cells of the male +Fate of the Germs.+ The fate of all these vast numbers of syphilitic germs, distributed over the whole body at the height of the disease, is one of the most remarkable imaginable As the acute secondary stage passes, whether the patient is treated or not, by far the larger... sores and under the skin in closed sores The nervous system, the walls of the blood-vessels, the internal organs, such as the liver and spleen, the bones and the bone-marrow, contain them They are not, however, apparently found in the secretions of the sweat glands, but, on the other hand, they have been shown to be present in the breast milk of nursing mothers who have active syphilis The seminal fluid... invariable The mother may abort once at the third month, and with the next pregnancy bear a living syphilitic child The living syphilitic children are usually the results of infection in the later months of the child's life inside its mother, or are the result of higher resistance to the disease on the part of the child or of the efficient treatment of the mother's syphilis +Variations on the Rule.+... part in the fight against syphilis If, for example, the chancre is on the genitals, the glands in the groin will be the first ones affected If it is on the lip, the neck glands become swollen The affected glands actually contain the germs which have made their way to them through lymph channels under the skin When the glands begin to swell, the critical period of limitation of the disease to the starting-point... sore on the body If the same thing happened in all the out-of -the- way corners of the body, the cure would be complete The natural result of removing the cause of the disease in this fashion is that the sores produced by it heal up They heal with a speed and completeness that is an even greater marvel than the action of mercury The more superficial the eruption, the quicker it vanishes, so that in the course... STAGE +The Spread of the Germs Over the Body.+ The secondary stage of syphilis, like the primary stage, is an arbitrary division whose beginning and ending can scarcely be sharply defined Broadly speaking, the secondary stage of syphilis is the one in which the infection ceases to be confined to the neighborhood of the chancre and affects the entire body The spread of the germs of the disease to the lymph-glands... result of the enormous mass of evidence which the Wassermann test has brought to light about the condition of mothers who bear syphilitic children, but themselves show no outward sign of the disease It is now generally believed that there is no transmission of syphilis to the child by its father, the father's share of responsibility for the syphilis lying in his having infected the mother None the less,... killed by the germs of the disease, and is cast out by the womb as if it were a foreign body Usually the more active the mother's syphilis, the sooner the child is infected and killed, and the earlier in her pregnancy will she abort Later in the disease the child may not be infected until well along, and may die only at the ninth month or just as it is born In other words, the rule is that the abortions... based on outward signs of the disease rather than on a real understanding of what goes on in the body during these periods The primary stage was supposed to extend from the appearance of the first sore or chancre to the time when an eruption appeared over the whole body Since the discovery of the Spirochæta pallida, the germ of the disease, our knowledge of what the germ does in the body, where it goes, . XV Chapter XVI Chapter XVI The Third Great Plague The Project Gutenberg EBook of The Third Great Plague, by John H. Stokes This eBook is for the use of anyone anywhere. understood by the world at large. Cancer, still of unknown cause, is the second great modern plague. The third great plague is syphilis, a disease which, in these